乙型肝炎复制指标的相关性分析及其临床应用价值研究

 目的探讨HBeAg、HBcAg、Pres1Ag、HBcAb和HBV DNA的关系及其临床应用评价.方法Pres1Ag和HBV M检测采用酶免法,HBV DNA采用荧光探针技术定量PCR法,HBcAg采用固相放射免疫法.结果5项复制指标分别在HBV M不同模式组检出率不等同;HBcAb(+)组的HBV DNA和HBcAg阳性率显著高于HBcAb(-)的HBV M模式组(P<0.01);若以HBV DNA检测阳性为HBV复制金标准,HBcAg检测符合率(83.2%)显著高于其他指标(P<0.01),而HBcAb检测特异性和HBeAg检测灵敏度过低.结论(1)HBcAg与HBV DNA相关性最好.(2)5项指标评价HBV复制的临床意义为:HBV DNA>HBcAg>Pres1Ag>HBeAg>HBcAb.(3)HBcAb仅仅可作为HBV复制的初筛指标.

Relationships and clinical application of hepatitis B replication markers

Objective To investigate the relationships between HBeAg, HBcAg, Pres1Ag, HBcAb and HBV DNA. Methods Pres1Ag and HBV M were determined by enzyme immunoassay, contents of serum HBV DNA by PCR - fluorescence qualification, and HBcAg by solid phase radioimmunoassay.Results The positive rates of the five parameters varied with HBV M groups.The positive rates of HBV DNA and HBcAg in the HBcAb( ) group were higher than that in the HBcAb( - ) group ( P < 0.01) .Taking HBV DNA ( ) for the gold standard of HBV replication, the effective rate of HBcAg was higher than that of other indexes ( P < 0.01). However, the specificity of HBcAb and the sensitivity of HBeAg were too low. Conclusions (1)The relationship between HBcAg and HBV DNA was highest. (2)The clinical significance of five replication marks decreased in the following order:HBV DNA> HBcAg > Pres1Ag > HBeAg> HBcAb. (3)HBcAb was regarded as the primary screening index of HBV replication.